Pharmacogenomics goes live: training and pilot project launches

 
20 Mar 2019
Pharmacogenomics goes live: training and pilot project launches

In September 2018 our innovation arm, Ventures, announced the first large-scale, primary care-based genomics programme for New Zealand. 

We've now named Australian based genetics lab and experts myDNA, and Callaghan Innovation as our partners for the project.

myDNA was founded by Associate Professor Les Sheffield, who has been at the forefront of genetic research since the 1980s.

The team at myDNA consists of pharmacologists, molecular and clinical geneticists, researchers, genetic counsellors, nutritionists and sport dietitians who work together to provide genetic interpretations to inform an individual's health, medical and lifestyle decisions.

"We looked for a lot of things in a genetics partner, including "bullet proof" assurances that genetic data belonged to the patient, the data wouldn't be used for any other purposes and the sample tissue collected for the test is either destroyed or stored depending on the patient's wishes," says Ventures CEO John Macaskill-Smith. 

Working with Callaghan Innovation

Ventures has worked with Callaghan Innovation to secure funding for piloting the use of PGx, introducing precision/personalised prescribing and developing electronic clinical decision support tools. 

The program will see testing offered for free to patients across the Midlands region, who will be selected by their clinical and high needs criteria. This will include a range of clinical indicators. The results will be embedded into the patient's health records and will provide prompts and access to the latest international PGx prescribing guidelines for providers using the indiciTM health information platform.

The aim of the pilot is not only to vastly improve outcomes for patients, but also to explore and refine the use of PGx, helping to 'mainstream' it within the New Zealand health sector. 

Pilot study data will also help to build an enriched understanding of the unique New Zealand population, as currently very little is known about how Māori and Pacific People metabolise medications. Academic partners from Auckland and Otago medical schools are extremely excited to partner with Pinnacle for this part of the research, with a view to help with inequity issues faced in our current health system. We're also collaborating with iwi and M?ori health providers to ensure culturally appropriate procedures are in place alongside this initiative.

Training programme

GP's need to complete a short online training programme to be able to deliver medication reports. The training will also:
  • give Pinnacle GPs the specifics on how to start using PGx based prescribing in their daily practice - how to order kits for your practice, and the different kits available
  • introduce the pilot study - all practices will have patients eligible for inclusion in the study so get along to find out how to access funded tests for your patients. 

Protection for patients

Online today you'll find over 600 direct to consumer tests through hundreds of different international companies. From pooled genomic comparison services like Ancestry.com through to full genome disease-based screening which provides well patients with likelihood scores for developing life shortening diseases like cancer, and even to hyper diets and super sports screening. 

"What's really important to note is in the majority of these services individuals sacrifice the ownership and ongoing control of their personal DNA data with little thought to where it's going beyond the short-term transition of a returning report," says John.

In some countries the rules have been debated and governing legislation like the Genetic Information Non-discrimination Act which protects Americans from being treated unfairly because of differences in their DNA that may affect their health. This has seen a massive change in behaviour and a shift in the way services like 23andMe and patientslikeme operate and use DNA data.

"New Zealand is currently lacking these protections and this is one of the drivers for Pinnacle in helping provide a protective barrier for its patients, providers and the broader population until local social debate occurs and laws are developed," John adds.

Ventures has been exploring PGx with various partners including members of genomics Aotearoa, Auckland and Otago medical Schools, James and Wells, DHBs, PHARMAC, iwi and a range of other health organisations.  

"Our goal is to ensure patients and providers have access to a creditable and safe option around PGx. While individuals are free to use any service, many online services are not covered by New Zealand legislation and simply offer a report in return for the individual giving away the DNA," says John.

We believe with the way we've designed our service we are providing the greatest protection and management of genomic information currently available in New Zealand. The information is placed within an individual's health records and is governed by the various legislation that currently protects access to health information. This positioning of the data far exceeds the weak position of most online services and even exceeds the consent and regulations granted by most ethnic committees around genetic based research in New Zealand.

For more information

Contact project support Sophie Mannis, sophie.mannis@pinnacle.health.nz.